Breast asymmetry due to pectus excavatum - can I get insurance to cover?

Surgery for correction of pectus is usually covered by insurance if it is severe enough.  Getting breast implants with a mild or moderate pectus is unlikely to be covered, but you should contact your insurance carrier to be sure.

Thank you for the question. Insurance usually does not cover this kind of cosmetic surgery. It is best to consult with a board certified plastic surgeon. Good luck.

Thank you for your question.It is hard to answer if an insurance company will pay for anything, especially now when they do not want to pay for anything that is not life or death.  I would recommend getting the diagnosis and procedure codes from your doctor, then you can call the insurance to see if these are covered codes. If there is a possibility for them to be covered then the doctor can submit your information to get everything authorized through the insurance prior to your procedure. Good luck.

Generally speaking, breast augmentation for asymmetries related to pectus deformities are not considered medically necessary so it would be difficult to obtain coverage for your procedure.  That being said, you can always apply to your insurance company and see what happens.  Your surgeon will need to send in a letter and perhaps some corroborating photos to support your case for coverage.

Thank you for the question.  Patients with pectus excavatum often do very well with breast augmentation. The use of different sizes/profile breast implants are often very helpful when it comes to improving breast symmetry. In my experience, breast implants tend to help “camouflage” the concavity, making the cleavage area look deeper. Often times postoperatively is hard to know that the patient initially presented with pectus excavatum. 
Often, patients with pectus excavatum have medially sloped chest walls ( sloped towards the cleavage area); care must be taken during the breast implant pocket dissection to avoid the implants coming together too close in the sternal area.
Also, patients with pectus excavatum may have their nipple/areola complexes relatively medially positioned on their breasts; without intervention this inward leaning appearance of the nipple/areola does not improve with breast augmentation surgery.
 
I would suggest that you meet with well experienced board-certified plastic surgeons; ask to see lots of examples of his/her work and communicate your goals carefully as well.  Insurance company involvement is unlikely.
Best wishes. 

The chance your insurance will cover the surgery is not high but you never know until you ask. First, you need to find a plastic surgeon who takes insurance to examine you and submit the request to the insurance carrier. It will then be reviewed and either outright denied or a request for more information. Even then, it can be denied. I have not worked with insurance plans for a long time due to the difficulty in approval for things that should be covered. It sounds as though you have a significant difference in volume and shape so make sure you are seeing an experienced, board-certified plastic surgeon for your care.I wish you wellDr. Edwards

Insurance might cover surgery to correct your pectus deformity if you were having cardiac or pulmonary issues, or even back surgery, but not elective breast surgery for larger and more even breasts. Insurance does not consider elective breast surgery medically necessary.

Having been in this business for over 25 years, I have never been able to get congenital breast deformity covered by insurance, even with a pectus deformity. That said these are incredibly tricky cases and the the deformity that you describe is not that unusual. Be sure the board certified plastic surgeon you choose has experience specifically with this and can show you before an actor pictures of similar patients.  I’m sure you’ll be happy with your decision to proceed either way.  Good luck! Dr. Z

Every insurance is different.  Some cover things, some don't.  Some promise, then don't pay.  The first step is to call your insurance company and see what doctor in your area they work with.  Then go see that doc and ask about insurance company.  They should not only precertify, but PREDETERMINE the case to see if they will pay.  Predetermination is an extra step in the process which doesn't guarantee but helps to make sure they will cover the costs.  Best of luck!

Unfortunately, regardless of your genetic starting point, pectus, and asymmetry, these are not considered health or life threatening conditions and breast augmentation is considered not medically necessary. Consequently, I am not aware that any insurance will cover this procedure. Sorry.